The Florida Board of Medicine Friday took a first step toward banning gender-affirming care for transgender youth.The board voted to “consider” guidelines proposed by the state’s surgeon general that reject standards of care endorsed by major medical associations, The Independent reports.

The action doesn’t limit such care immediately but starts the process of doing so. “The decision from the governor-appointed board initiates a formal rule-changing process that would deny trans youth from receiving such care and forcibly detransition them,” the publication explains. “The process could take several months.”The guidance from Surgeon General Joseph Ladapo says people under 18 should not be prescribed puberty blockers or hormone treatment, should not undergo gender-affirming surgery, and should not even transition socially.

Doctors do not recommend surgery for this population, but treatment with puberty blockers and hormones is common (and largely reversible), as is social transition.